He’s not the President. Stop treating him like one.

Elon Musk tweeted from Qatar, where he was watching the World Cup Final with Jared Kushner.

Musk's subsequent Tweets were as normal, basic, and bland as anyone's from a World Cup Final: It's depressing to see the world's richest man looking at his phone during a grand ceremony. Rich guy goes to rich guy event didn't seem important.

Before Musk posted his should-I-step-down-at-Twitter poll, CNN ran a long segment asking if it was hypocritical for him to reveal his real-time location after defending his (very dumb) suspension of several journalists for (supposedly) revealing his assassination coordinates by linking to a site that tracks Musks private jet. It was hard to ignore CNN's hypocrisy: It covered Musk as Twitter CEO like President Trump. EVERY TRUMP STORY WAS BASED ON HIM SAYING X, THEN DOING Y. Trump would do something horrific, lie about it, then pretend it was fine, then condemn a political rival who did the same thing, be called hypocritical, and so on. It lasted four years. Exhausting.

It made sense because Trump was the President of the United States. The press's main purpose is to relentlessly cover and question the president.

It's strange to say this out. Twitter isn't America. Elon Musk isn't a president. He maintains a money-losing social media service to harass and mock people he doesn't like. Treating Musk like Trump, as if he should be held accountable like Trump, shows a startling lack of perspective. Some journalists treat Twitter like a country.

The compulsive, desperate way many journalists utilize the site suggests as much. Twitter isn't the town square, despite popular belief. It's a place for obsessives to meet and converse. Journalists say they're breaking news. Their careers depend on it. They can argue it's a public service. Nope. It's a place lonely people go to speak all day. Twitter. So do journalists, Trump, and Musk. Acting as if it has a greater purpose, as if it's impossible to break news without it, or as if the republic is in peril is ludicrous. Only 23% of Americans are on Twitter, while 25% account for 97% of Tweets. I'd think a large portion of that 25% are journalists (or attention addicts) chatting to other journalists. Their loudness makes Twitter seem more important than it is. Nope. It's another stupid website. They were there before Twitter; they will be there after Twitter. It’s just a website. We can all get off it if we want. Most of us aren’t even on it in the first place.

Musk is a website-owner. No world leader. He's not as accountable as Trump was. Musk is cable news's primary character now that Trump isn't (at least for now). Becoming a TV news anchor isn't as significant as being president. Elon Musk isn't as important as we all pretend, and Twitter isn't even close. Twitter is a dumb website, Elon Musk is a rich guy going through a midlife crisis, and cable news is lazy because its leaders thought the entire world was on Twitter and are now freaking out that their playground is being disturbed.

I’ve said before that you need to leave Twitter, now. But even if you’re still on it, we need to stop pretending it matters more than it does. It’s a site for lonely attention addicts, from the man who runs it to the journalists who can’t let go of it. It’s not a town square. It’s not a country. It’s not even a successful website. Let’s stop pretending any of it’s real. It’s not.

The Industrial Revolution's Curse: Why One Age's Power Prevents the Next Ones

A surprising fact. Recently, Big Oil's 1970s climate change projections were disturbingly accurate. Of course, we now know that it worked tirelessly to deny climate change, polluting our societies to this day. That's a small example of the Industrial Revolution's curse.

Let me rephrase this nuanced and possibly weird thought. The chart above? Disruptive science is declining. The kind that produces major discoveries, new paradigms, and shattering prejudices.

Not alone. Our civilisation reached a turning point suddenly. Progress stopped and reversed for the first time in centuries.

The Industrial Revolution's Big Bang started it all. At least some humans had riches for the first time, if not all, and with that wealth came many things. Longer, healthier lives since now health may be publicly and privately invested in. For the first time in history, wealthy civilizations could invest their gains in pure research, a good that would have sounded frivolous to cultures struggling to squeeze out the next crop, which required every shoulder to the till.

So. Don't confuse me with the Industrial Revolution's curse. Industry progressed. Contrary. I'm claiming that the Big Bang of Progress is slowing, plateauing, and ultimately reversing. All social indicators show that. From progress itself to disruptive, breakthrough research, everything is slowing down.

It's troubling. Because progress slows and plateaus, pre-modern social problems like fascism, extremism, and fundamentalism return. People crave nostalgic utopias when they lose faith in modernity. That strongman may shield me from this hazardous life. If I accept my place in a blood-and-soil hierarchy, I have a stable, secure position and someone to punch and detest. It's no coincidence that as our civilization hits a plateau of progress, there is a tsunami pulling the world backwards, with people viscerally, openly longing for everything from theocracy to fascism to fundamentalism, an authoritarian strongman to soothe their fears and tell them what to do, whether in Britain, heartland America, India, China, and beyond.

However, one aspect remains unknown. Technology. Let me clarify.

How do most people picture tech? Say that without thinking. Most people think of social media or AI. Well, small correlation engines called artificial neurons are a far cry from biological intelligence, which functions in far more obscure and intricate ways, down to the subatomic level. But let's try it.

Today, tech means AI. But. Do you foresee it?

Consider why civilisation is plateauing and regressing. Because we can no longer provide the most basic necessities at the same rate. On our track, clean air, water, food, energy, medicine, and healthcare will become inaccessible to huge numbers within a decade or three. Not enough. There isn't, therefore prices for food, medicine, and energy keep rising, with occasional relief.

Why our civilizations are encountering what economists like me term a budget constraint—a hard wall of what we can supply—should be evident. Global warming and extinction. Megafires, megadroughts, megafloods, and failed crops. On a civilizational scale, good luck supplying the fundamentals that way. Industrial food production cannot feed a planet warming past two degrees. Crop failures, droughts, floods. Another example: glaciers melt, rivers dry up, and the planet's fresh water supply contracts like a heart attack.

Now. Let's talk tech again. Mostly AI, maybe phone apps. The unsettling reality is that current technology cannot save humanity. Not much.

AI can do things that have become cliches to titillate the masses. It may talk to you and act like a person. It can generate art, which means reproduce it, but nonetheless, AI art! Despite doubts, it promises to self-drive cars. Unimportant.

We need different technology now. AI won't grow crops in ash-covered fields, cleanse water, halt glaciers from melting, or stop the clear-cutting of the planet's few remaining forests. It's not useless, but on a civilizational scale, it's much less beneficial than its proponents claim. By the time it matures, AI can help deliver therapy, keep old people company, and even drive cars more efficiently. None of it can save our culture.

Expand that scenario. AI's most likely use? Replacing call-center workers. Support. It may help doctors diagnose, surgeons orient, or engineers create more fuel-efficient motors. This is civilizationally marginal.

Non-disruptive. Do you see the connection with the paper that indicated disruptive science is declining? AI exemplifies that. It's called disruptive, yet it's a textbook incremental technology. Oh, cool, I can communicate with a bot instead of a poor human in an underdeveloped country and have the same or more trouble being understood. This bot is making more people unemployed. I can now view a million AI artworks.

AI illustrates our civilization's trap. Its innovative technologies will change our lives. But as you can see, its incremental, delivering small benefits at most, and certainly not enough to balance, let alone solve, the broader problem of steadily dropping living standards as our society meets a wall of being able to feed itself with fundamentals.

Contrast AI with disruptive innovations we need. What do we need to avoid a post-Roman Dark Age and preserve our civilization in the coming decades? We must be able to post-industrially produce all our basic needs. We need post-industrial solutions for clean water, electricity, cement, glass, steel, manufacture for garments and shoes, starting with the fossil fuel-intensive plastic, cotton, and nylon they're made of, and even food.

Consider. We have no post-industrial food system. What happens when crop failures—already dangerously accelerating—reach a critical point? Our civilization is vulnerable. Think of ancient civilizations that couldn't survive the drying up of their water sources, the failure of their primary fields, which they assumed the gods would preserve forever, or an earthquake or sickness that killed most of their animals. Bang. Lost. They failed. They splintered, fragmented, and abandoned vast capitols and cities, and suddenly, in history's sight, poof, they were gone.

We're getting close. Decline equals civilizational peril.

We believe dumb notions about AI becoming disruptive when it's incremental. Most of us don't realize our civilization's risk because we believe these falsehoods. Everyone should know that we cannot create any thing at civilizational scale without fossil fuels. Most of us don't know it, thus we don't realize that the breakthrough technologies and systems we need don't manipulate information anymore. Instead, biotechnologies, largely but not genes, generate food without fossil fuels.

We need another Industrial Revolution. AI, apps, bots, and whatnot won't matter unless you think you can eat and drink them while the world dies and fascists, lunatics, and zealots take democracy's strongholds. That's dramatic, but only because it's already happening. Maybe AI can entertain you in that bunker while society collapses with smart jokes or a million Mondrian-like artworks. If civilization is to survive, it cannot create the new Industrial Revolution.

The revolution has begun, but only in small ways. Post-industrial fundamental systems leaders are developing worldwide. The Netherlands is leading post-industrial agriculture. That's amazing because it's a tiny country performing well. Correct? Discover how large-scale agriculture can function, not just you and me, aged hippies, cultivating lettuce in our backyards.

Iceland is leading bioplastics, which, if done well, will be a major advance. Of sure, microplastics are drowning the oceans. What should we do since we can't live without it? We need algae-based bioplastics for green plastic.

That's still young. Any of the above may not function on a civilizational scale. Bioplastics use algae, which can cause problems if overused. None of the aforementioned indicate the next Industrial Revolution is here. Contrary. Slowly.

We have three decades until everything fails. Before life ends. Curtain down. No more fields, rivers, or weather. Freshwater and life stocks have plummeted. Again, we've peaked and declined in our ability to live at today's relatively rich standards. Game over—no more. On a dying planet, producing the fundamentals for a civilisation that left it too late to construct post-industrial systems becomes next to impossible, with output dropping faster and quicker each year, quarter, and day.

Too slow. That's because it's not really happening. Most people think AI when I say tech. I get a politicized response if I say Green New Deal or Clean Industrial Revolution. Half the individuals I talk to have been politicized into believing that climate change isn't real and that any breakthrough technical progress isn't required, desirable, possible, or genuine. They'll suffer.

The Industrial Revolution curse. Every revolution creates new authorities, which ossify and refuse to relinquish their privileges. For fifty years, Big Oil has denied climate change, even though their scientists predicted it. We also have a software industry and its venture capital power centers that are happy for the average person to think tech means chatbots, not being able to produce basics for a civilization without destroying the planet, and billionaires who buy comms platforms for the same eye-watering amount of money it would take to save life on Earth.

The entire world's vested interests are against the next industrial revolution, which is understandable since they were established from fossil money. From finance to energy to corporate profits to entertainment, power in our world is the result of the last industrial revolution, which means it has no motivation or purpose to give up fossil money, as we are witnessing more brutally out in the open.

Thus, the Industrial Revolution's curse—fossil power—rules our globe. Big Agriculture, Big Pharma, Wall St., Silicon Valley, and many others—including politics, which they buy and sell—are basically fossil power, and they have no interest in generating or letting the next industrial revolution happen. That's why tiny enterprises like those creating bioplastics in Iceland or nations savvy enough to shun fossil power, like the Netherlands, which has a precarious relationship with nature, do it. However, fossil power dominates politics, economics, food, clothes, energy, and medicine, and it has no motivation to change.

Allow disruptive innovations again. As they occur, its position becomes increasingly vulnerable. If you were fossil power, would you allow another industrial revolution to destroy its privilege and wealth?

You might, since power and money haven't corrupted you. However, fossil power prevents us from building, creating, and growing what we need to survive as a society. I mean the entire economic, financial, and political power structure from the last industrial revolution, not simply Big Oil. My friends, fossil power's chokehold over our society is likely to continue suffocating the advances that could have spared our civilization from a decline that's now here and spiraling closer to oblivion.

ZERO GRACE/ZERO MALICE

Amazon's purchase of One Medical could speed up American healthcare

The U.S. healthcare industry is a 7-ton seal bleeding at sea. Predators are circling. Unearned margin: price increases relative to inflation without quality improvements. Amazon is the 11-foot megalodon with 7-inch teeth. Amazon is no longer circling... but attacking.

In 2020 dollars, per capita U.S. healthcare spending increased from $2,968 in 1980 to $12,531. The result is a massive industry with 13% of the nation's workers and a fifth of GDP.

Doctor No

In 40 years, healthcare has made progress. From 73.7 in 1980 to 78.8 in 2019, life expectancy rose (before Covid knocked it back down a bit). Pharmacological therapies have revolutionized, and genetic research is paying off. The financial return, improvement split by cost increases, is terrible. No country has expense rises like the U.S., and no one spends as much per capita as we do. Developed countries have longer life expectancies, healthier populations, and less economic hardship.

Two-thirds of U.S. personal bankruptcies are due to medical expenses and/or missed work. Mom or Dad getting cancer could bankrupt many middle-class American families. 40% of American adults delayed or skipped needed care due to cost. Every healthcare improvement seems to have a downside. Same pharmacological revolution that helped millions caused opioid epidemic. Our results are poor in many areas: The U.S. has a high infant mortality rate.

Healthcare is the second-worst retail industry in the country. Gas stations are #1. Imagine walking into a Best Buy to buy a TV and a Blue Shirt associate requests you fill out the same 14 pages of paperwork you filled out yesterday. Then you wait in a crowded room until they call you, 20 minutes after the scheduled appointment you were asked to arrive early for, to see the one person in the store who can talk to you about TVs, who has 10 minutes for you. The average emergency room wait time in New York is 6 hours and 10 minutes.

If it's bad for the customer, it's worse for the business. Physicians spend 27% of their time helping patients; 49% on EHRs. Documentation, order entry, billing, and inbox management. Spend a decade getting an M.D., then become a bureaucrat.

No industry better illustrates scale diseconomies. If we got the same return on healthcare spending as other countries, we'd all live to 100. We could spend less, live longer and healthier, and pay off the national debt in 15 years. U.S. healthcare is the worst ever.

What now? Competition is at the heart of capitalism, the worst system of its kind.

Priority Time

Amazon is buying One Medical for $3.9 billion. I think this deal will liberate society. Two years in, I think One Medical is great. When I got Covid, I pressed the One Medical symbol on my phone; a nurse practitioner prescribed Paxlovid and told me which pharmacies had it in stock.

Amazon enables the company's vision. One Medical's stock is down to $10 from $40 at the start of 2021. Last year, it lost $250 million and needs cash (Amazon has $60 billion). ONEM must grow. The service has 736,000 members. Half of U.S. households have Amazon Prime. Finally, delivery. One Medical is a digital health/physical office hybrid, but you must pick up medication at the pharmacy. Upgrade your Paxlovid delivery time after a remote consultation. Amazon's core competency means it'll happen. Healthcare speed and convenience will feel alien.

It's been a long, winding road to disruption. Amazon, JPMorgan, and Berkshire Hathaway formed Haven four years ago to provide better healthcare for their 1.5 million employees. It rocked healthcare stocks the morning of the press release, but folded in 2021.

Amazon Care is an employee-focused service. Home-delivered virtual health services and nurses. It's doing well, expanding nationwide, and providing healthcare for other companies. Hilton is Amazon Care's biggest customer. The acquisition of One Medical will bring 66 million Prime households capital, domain expertise, and billing infrastructure. Imagine:

"Alexa, I'm hot and my back hurts."

"Connecting you to a Prime doctor now."

Want to vs. Have to

I predicted Amazon entering healthcare years ago. Why? For the same reason Apple is getting into auto. Amazon's P/E is 56, double Walmart's. The corporation must add $250 billion in revenue over the next five years to retain its share price. White-label clothes or smart home products won't generate as much revenue. It must enter a huge market without scale, operational competence, and data skills.

Current Situation

Healthcare reform benefits both consumers and investors. In 2015, healthcare services had S&P 500-average multiples. The market is losing faith in public healthcare businesses' growth. Healthcare services have lower EV/EBITDA multiples than the S&P 500.

Amazon isn't the only prey-hunter. Walmart and Alibaba are starting pharmacies. Uber is developing medical transportation. Private markets invested $29 billion in telehealth last year, up 95% from 2020.

The pandemic accelerated telehealth, the immediate unlock. After the first positive Covid case in the U.S., services that had to be delivered in person shifted to Zoom... We lived. We grew. Video house calls continued after in-person visits were allowed. McKinsey estimates telehealth visits are 38 times pre-pandemic levels. Doctors adopted the technology, regulators loosened restrictions, and patients saved time. We're far from remote surgery, but many patient visits are unnecessary. A study of 40 million patients during lockdown found that for chronic disease patients, online visits didn't affect outcomes. This method of care will only improve.

Amazon's disruption will be significant and will inspire a flood of capital, startups, and consumer brands. Mark Cuban launched a pharmacy that eliminates middlemen in January. Outcome? A 90-day supply of acid-reflux medication costs $17. Medicare could have saved $3.6 billion by buying generic drugs from Cuban's pharmacy. Other apex predators will look at different limbs of the carcass for food. Nike could enter healthcare via orthopedics, acupuncture, and chiropractic. LVMH, L'Oréal, and Estée Lauder may launch global plastic surgery brands. Hilton and Four Seasons may open hospitals. Lennar and Pulte could build "Active Living" communities that Nana would leave feet first, avoiding the expense and tragedy of dying among strangers.

Risks

Privacy matters: HIV status is different from credit card and billing address. Most customers (60%) feel fine sharing personal health data via virtual technologies, though. Unavoidable. 85% of doctors believe data-sharing and interoperability will become the norm. Amazon is the most trusted tech company for handling personal data. Not Meta: Amazon.

What about antitrust, then?

Amazon should be required to spin off AWS and/or Amazon Fulfillment and banned from promoting its own products. It should be allowed to acquire hospitals. One Medical's $3.9 billion acquisition is a drop in the bucket compared to UnitedHealth's $498 billion market valuation.

Antitrust enforcement shouldn't assume some people/firms are good/bad. It should recognize that competition is good and focus on making markets more competitive in each deal. The FTC should force asset divestitures in e-commerce, digital marketing, and social media. These companies can also promote competition in a social ill.

U.S. healthcare makes us fat, depressed, and broke. Competition has produced massive value and prosperity across most of our economy.

Dear Amazon … bring it.

Most don't understand the issue until it's too late.

My first startup was what entrepreneurs call the hardest. A two-sided marketplace.

Two-sided marketplaces are the hardest startups because founders must solve the chicken or the egg conundrum.

A two-sided marketplace needs suppliers and buyers. Without suppliers, buyers won't come. Without buyers, suppliers won't come. An empty marketplace and a founder striving to gain momentum result.

My first venture made me a struggling founder seeking to achieve traction for a two-sided marketplace. The company failed, and I vowed never to start another like it.

I didn’t. Unfortunately, my second venture was almost as hard. It failed like the second-hardest startup.

What kind of startup is the second-hardest?

The second-hardest startup, which is almost as hard to develop, is rarely discussed in the startup community. Because of this, I predict more founders fail each year trying to develop the second-toughest startup than the hardest.

Fairly, I have no proof. I see many startups, so I have enough of firsthand experience. From what I've seen, for every entrepreneur developing a two-sided marketplace, I'll meet at least 10 building this other challenging startup.

I'll describe a startup I just met with its two co-founders to explain the second hardest sort of startup and why it's so hard. They created a financial literacy software for parents of high schoolers.

The issue appears plausible. Children struggle with money. Parents must teach financial responsibility. Problems?

It's possible.

Buyers and users are different.

Buyer-user mismatch.

The financial literacy app I described above targets parents. The parent doesn't utilize the app. Child is end-user. That may not seem like much, but it makes customer and user acquisition and onboarding difficult for founders.

The difficulty of a buyer-user imbalance

The company developing a product faces a substantial operational burden when the buyer and end customer are different. Consider classic firms where the buyer is the end user to appreciate that responsibility.

Entrepreneurs selling directly to end users must educate them about the product's benefits and use. Each demands a lot of time, effort, and resources.

Imagine selling a financial literacy app where the buyer and user are different. To make the first sale, the entrepreneur must establish all the items I mentioned above. After selling, the entrepreneur must supply a fresh set of resources to teach, educate, or train end-users.

Thus, a startup with a buyer-user mismatch must market, sell, and train two organizations at once, requiring twice the work with the same resources.

The second hardest startup is hard for reasons other than the chicken-or-the-egg conundrum. It takes a lot of creativity and luck to solve the chicken-or-egg conundrum.

The buyer-user mismatch problem cannot be overcome by innovation or luck. Buyer-user mismatches must be solved by force. Simply said, when a product buyer is different from an end-user, founders have a lot more work. If they can't work extra, their companies fail.